Retail and Urgent Care Articles
In patients given a new opiate prescription in the ED, 13.7% had persistent or high risk use over the next year. Higher doses led to greater risk, but even appropriate lower doses were associated with up to a 10% risk.
Physicians who wrote for the most antibiotics were also the ones who diagnosed sinusitis most often. To justify writing for an antibiotic, there was a coding bias to call it “sinusitis” when in fact, it probably was just a cold.
Fluoroquinolone (FQ) antibiotics were associated with an increased odds of serious arrhythmic event (SAE) from 7 up to 90 days after taking them.
Showing compassion to patients in the ED with a life threatening emergency reduced the odds of PTSD at one month.
Gabapentinoids were associated with increased risk of suicidal behavior, overdose, injuries, and car crashes.
The CDC no longer recommends* annual TB screening of health care providers in the absence of a known exposure or ongoing transmission.
Use of tramadol post-op was associated with an increased risk of prolonged use compared with other short acting opiates.
Examining the hand and wrist is challenging. Watch this video on NEJM to learn proper techniques and how to diagnose 9 common hand/wrist problems.
Sometimes sore throat isn’t just sore throat - it could be a life threatening complication. Learn about Lemierre’s syndrome with this quick-hitter teaching case from NEJM.
Gabapentinoids play a limited role for specific types of neuropathic pain, and pain reduction is modest at best. Side effects of dizziness, somnolence, and gait problems occur frequently.
There was no benefit in functional outcome or pain at one week by using ibuprofen + either baclofen, metaxolone, or tizanidine over ibuprofen + placebo.
This letter to the editor presents compelling reasons why a pelvic exam is needed to diagnose cervicitis or pelvic inflammatory disease.
The U.S. is currently in a measles outbreak. So, don’t miss this quick spoon-feed refresher. You will learn something new.
Removal of the ARISTOTLE study (known to contain falsified data) from 22 subsequent meta-analyses led to a change in the conclusion of these meta-analyses nearly half the time. Research misconduct hurts people.
The Pediatric Advanced Life Support (PALS)/Advanced Trauma Life Support (ATLS) formula to define hypotension in children (i.e. 5th percentile SBP) seems to be a good compromise between German and U.S. population norms for children. The formula is: Low SBP = <70 + 2(age in years).
Interrater agreement on whether a child’s throat was red or not was “fair” (aka…pretty bad), although agreement was significantly better when grading tonsillar hypertrophy.
In this large cohort study of over 1.8 million pregnancies, first trimester ondansetron use was not associated with cardiac malformations or total congenital malformations. However, there was a small increased risk of oral clefts (3 additional cases per 10,000 women treated).
Penicillin allergy is a lot less common than patients report. A low-risk history could allow you to prescribe it in the ED or clinic.
”Tachypnea at triage, chronic ulcers, history of MRSA colonization or infection, and cellulitis within the past year,” were the risk factors associated with failure of oral antibiotic therapy for non-purulent cellulitis.
The overall sensitivity of the Wood’s lamp, compared to the gold standard slit lamp, to establish the diagnosis of common corneal and conjunctival abnormalities was found to be an abysmal 52%.
This is the IDSA influenza guideline, updated from the previous one in 2009. It covers testing, treatment, complications, and more.
Pelvic examination added little to clinical judgment when evaluating for sexually transmitted infections in young women.
These are the top articles from 2018.
Topical antibiotic use for bacterial conjunctivitis was associated with improved rate of clinical cure compared to placebo. For early and late clinical cure with topical antibiotics, the NNT was 9 and 11, respectively.
In premenopausal women with recurrent cystitis, drinking more water on a daily basis can reduce episodes of cystitis.
Probiotics decrease the risk of C. difficile infection in adults and children taking antibiotics and may reduce overall adverse events like cramping, nausea, or diarrhea.
There was no difference between a regular medical mask and N-95 mask worn by healthcare workers in preventing influenza or any other respiratory infection.
Adults with cough <3weeks or 3-8 weeks with post-tussive vomiting or whooping should be treated for pertussis; those with fever or without paroxysmal cough should be considered to have an alternate diagnosis. Children with <4 weeks of cough and post-tussive vomiting may have pertussis, but it was much less clear than in adults.
It took an extra 67 seconds when not prescribing an antibiotic to patients with acute respiratory infection compared to visits in which an antibiotic was prescribed.
Highly resistant, extended spectrum β-lactamase (ESBL) producing Enterobacteriaceae in the urine are becoming increasingly common in unexpected patients in the ED.